TY - JOUR
T1 - Personalized endoscopy in complex malignant hilar biliary strictures
AU - Boskoski, Ivo
AU - Schepis, Tommaso
AU - Tringali, Andrea
AU - Familiari, Pietro
AU - Bove, Vincenzo
AU - Attili, Fabia
AU - Landi, Rosario
AU - Perri, Vincenzo
AU - Costamagna, Guido
PY - 2021
Y1 - 2021
N2 - Malignant hilar biliary obstruction (HBO) represents a complex clinical condition in terms of diagnosis, surgical and medical treatment, endoscopic approach, and palliation. The main etiology of malignant HBO is hilar cholangiocarcinoma that is considered an aggressive biliary tract’s cancer and has still today a poor prognosis. Endoscopy plays a crucial role in malignant HBO from the diagnosis to the palliation. This technique allows the collection of cytological or histological samples, direct visualization of the suspect malignant tissue, and an echoendoscopic evaluation of the primary tumor and its locoregional staging. Because obstructive jaundice is the most common clinical presentation of malignant HBO, endoscopic biliary drainage, when indicated, is the preferred treatment over the percutaneous approach. Several endoscopic techniques are today available for both the diagnosis and the treatment of biliary obstruction. The choice among them can differ for each clinical scenario. In fact, a personalized endoscopic approach is mandatory in order to perform the proper procedure in the singular patient.
AB - Malignant hilar biliary obstruction (HBO) represents a complex clinical condition in terms of diagnosis, surgical and medical treatment, endoscopic approach, and palliation. The main etiology of malignant HBO is hilar cholangiocarcinoma that is considered an aggressive biliary tract’s cancer and has still today a poor prognosis. Endoscopy plays a crucial role in malignant HBO from the diagnosis to the palliation. This technique allows the collection of cytological or histological samples, direct visualization of the suspect malignant tissue, and an echoendoscopic evaluation of the primary tumor and its locoregional staging. Because obstructive jaundice is the most common clinical presentation of malignant HBO, endoscopic biliary drainage, when indicated, is the preferred treatment over the percutaneous approach. Several endoscopic techniques are today available for both the diagnosis and the treatment of biliary obstruction. The choice among them can differ for each clinical scenario. In fact, a personalized endoscopic approach is mandatory in order to perform the proper procedure in the singular patient.
KW - Confocal laser endomicroscopy
KW - Endoscopic retrograde cholangiopancreatography
KW - Endoscopic ultrasound
KW - Malignant hilar strictures
KW - Peroral cholangioscopy
KW - Personalized endoscopy
KW - Plastic biliary stents
KW - Self-expandable metal stents
KW - Confocal laser endomicroscopy
KW - Endoscopic retrograde cholangiopancreatography
KW - Endoscopic ultrasound
KW - Malignant hilar strictures
KW - Peroral cholangioscopy
KW - Personalized endoscopy
KW - Plastic biliary stents
KW - Self-expandable metal stents
UR - http://hdl.handle.net/10807/168744
U2 - 10.3390/jpm11020078
DO - 10.3390/jpm11020078
M3 - Article
SN - 2075-4426
VL - 11
SP - 1
EP - 21
JO - Journal of Personalized Medicine
JF - Journal of Personalized Medicine
ER -